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Providence Executive Director, RCS Enterprise Denials Management in Portland, Oregon

Description:

THE ROLE

The Executive Director for the RCS Enterprise Denials Management is responsible for all aspects of Revenue Cycle denials, with direct operational accountability for technical and clinical denials across the enterprise. This leader is responsible for developing and executing a strategic plan to establish and manage a denials center of excellence, adhering to the goals of the denials management program, in partnership with the leaders of PSJH RCS Services. This position will have responsibility for participation in the leadership of RCS directors and managers to ensure denials activities are standardized across Providence St. Joseph Health, and that all policies, procedures, and strategies adhere to the guidance and vision of the centralized Revenue Cycle function.

Partners with the system level leadership on Revenue Cycle process improvement, training, technology innovation, analytics, compliance, contracting and vendor management. The Executive Director of the RCS Enterprise Denials Management will continually review the current state and work with the Associate Vice President of Denials and Underpayments and other PSJH Senior Revenue Cycle leaders to move the organization to leading practices. The Executive Director RCS Enterprise Denials Management is responsible to ensure policies and procedures are current and enforced, business practices are compliant, and a high level of patient and customer satisfaction is maintained across the region. Promotes an environment shaped by health, healing, hope, diversity, and mutual respect. Is self-directed and requires minimal supervision.

ESSENTIAL FUNCTIONS

  • Develop, evaluate monitors and communicate the long and short term strategic objective of the revenue cycle denials function, ensuring consistency and alignment with the strategic objectives of the centralized revenue cycle organization, and PSJH. Responsible to achieve annual performance goals as established by the Chief Revenue Cycle Officer for PSJH

  • Develop and execute a detailed plan to improve overall denial performance in the revenue cycle and to continually collaborate with patient access, HIM, case management, billing team and contracting leadership to improve registration accuracy, coding accuracy, reduce days in AR, increase cash collections, reduce bad debt, eliminate write-offs due to revenue process issues and improve customer and patient satisfaction

  • Provide shared operational leadership to all ministries in the organization related to denials. Provide shared leadership and supervision to the areas of oversight.

  • Partner with other Revenue Cycle leadership to lead the development and implementation of policies, procedures and workflows which impact net revenue cash flow or performance efficiency across the Revenue Cycle function that align with the strategic direction and standardization for all of PSJH.

  • Partner with system wide Revenue Cycle leadership to develop process improvement opportunities, training, technology innovation, analytics, compliance and vendor management to meet denial improvement and maintained industry best practice needs.

  • Collaborate with other PSJH ministries and provides leadership in communicating consistent information and data regarding performance.

  • Collaborate with PSJH Contracting to understand contract specifics and provide PSJH Contracting with data to support negotiations with payers and development of contracting strategies. Develop relationships and collaborate with leaders at the payer level to improve appeal turnaround and dispute resolution.

  • Manage and oversee the development of technology solutions to improve efficiencies and reduce the delays in workflow processes.

  • Develop and ensure that the activities of the denial processes are performed in accordance with state and federal regulations, mandated collection practices, all regulatory agencies including JCAHO, and are HIPAA compliant.

  • Develop and monitor an annual operational budget as well as any capital budget requests, and complete all fiduciary responsibilities.

  • Actively collaborates with the financial leaders across PSJH to ensure the goals and strategic initiatives are aligned and whenever feasible, operational procedures are standardized.

  • Exercise creative approaches to problem solving. Deals with conflict and problematic situations in an open and tactful manner respecting the dignity of others.

  • Interface/coordinate as needed to meet goals with ministry operational departments and information systems team.

  • Perform other duties as assigned.

Qualifications:

QUALIFICATIONS

Required experience and education for this position include:

  • Bachelor's Degree in Business, Healthcare Management, or related field; or equivalent educ/experience

  • 15 years related experience in healthcare, revenue cycle or finance; 10 years leadership experience, preferably with responsibilities that span multiple entities. Proven ability to work collaboratively in group settings with various stakeholders, including executive leadership and clinicians

  • Demonstrated experience with Denial Management and/or revenue cycle financial management in a healthcare setting

  • Demonstrated leadership skills to build, sustain and ensure a skilled and engaged workforce is in place

  • Knowledge of Epic workflows

  • Strong decision-making skills based upon a mixture of analysis, wisdom, experience, and judgment

  • Experience working with 3rd party vendors to integrate and optimize business solutions

  • Ability to lead cross-functional teams located across service areas

  • Proven ability to organize multiple projects, schedules, demand and to meet shifting priorities

  • Organizing, planning, facilitating, and coordinating skills

  • Excellent oral/written communication skills

  • Demonstrated success in leading large, complex change initiatives

  • Excellent leadership ability to include motivating & developing others

  • Excellent interpersonal skills and ability to work with all levels of management and staff.

Preferred experience and education for this position include:

  • MBA or MHA.

For information on our comprehensive range of benefits, visit:

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Leadership

Location: Oregon-Portland

Req ID: 292778

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